Lower Dose?

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I was diagnosed 3 months ago with Graves Disease.  My last blood test 9/9 shows my TSH is still <.01 but my Free T4 is now 1.4 (range .8-1.8) and Total T3 is 166 (range 80-200). 

My Dr. has me on the same dose, 7.5mg methimazole, for six more weeks. I was also taking 750mg average of acetyl carnitine a day and the week before my labs took 750-1250 a day. 

Currently, I dropped the acetyl carnitine and I'm only taking 7.5mg methimazole. Is that typical to stay on the same dose even if my Free T4 is in range?    Should I take just a little less, like 7.5mg one day and 7.25mg the next alternating days?

Would appreciate advice from those who have gone through this.  Many thanks!


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  • Posted

    My Free T3 and Free T4 immediately came down to the middle of the normal ranges on a dose of Methimazole 10 mg but my TSH was less than 0.001 and stayed that way for 2 years until I added supplements.  First tried Regular L-Carnitine 3,000 mg and my TSH rose to 0.12.  When that happened, my doc dropped my Methimazole dosage from 10 to 5 mg but I had recurrence of symptoms 2 weeks later so raised it to 7.5.  Then I added 1,000 mg of Acetyl-L-Carnitine to 1,000 mg of Regular L--Carnitine and my TSH rose to 0.70.  My doc then adjusted meds dosage gradually downward by 2.5 mg at a time and I adjusted supplements dosage as my labs, particularly my TSH improved.  While I was doing this, my Free T3 and T4 fell to the bottom of the range but never out of range.  I tolerated this because I really wanted to normalize my TSH.  Currently I am off meds and take 500 mg of Regular L-Carnitine, 1,000 IU of vitamin D (gelcaps) and Magnesium 150 mg.
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    • Posted

      Thanks for your reply Linda.  What would you do if you were me?  Stick with the 7.5mg or lower it?  My symptoms are leaning more hypo than hyper. 


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  • Posted

    Your TSH is still hyper, your Free T4 is at the top of the range and your Free T3 is also at the upper end.  You are not hypo.  I would get your doc to test your Total and Free Carnitine levels and vitamin and Magnesium levels.  Vitamin D is very important to good thyroid functioning.  Based on your carnitine results, you might need to take Regular L-Carnitine and a low dose of Acetyl (250 to 500 mg) to bring your TSH up and your other labs will go down.  Regular L-Carnitine will cause some rise in TSH but not much but it replaces the carnitine that is usually lost in hyperthyroid patients which causes muscle pains.  I basically did this routine because I really wanted my TSH level to come up into the normal range so my Methimazole dose could be lowered and I was willing to tolerate low levels of Free T3 and T4 as long as they did not go out of range.  Once you do this, that is you know your levels of carnitine, vitamin D and magnesium and if deficient are replacing them, then your doc can lower your meds dosage.  My Endo lowered mine by 2.5 mg at a time.  I would let your doc deal with the meds dosage and you monitor and adjust supplements.
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    • Posted

      Hello Linda, 

      i kind of lost my place here, but I did want you to know our suspicions were right. I have been diagnosed with Graves’ disease.

      Actually, I was glad to find that out. I also have osteopenia from my bone density test. My Endocrinologist says he can take care of both problems. I am relieved to know that I have a diagnosis and a plan to get better.

      i want to thank you for your support.


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  • Posted

    Your med history is not very clear...  Can you post every blood result and MMI, ALC dose since diagnosed~ (sorry, I have a problem with the question mark key on my keyboard againsad  

    My opinion: 3 months of MMI and ALC may not be long enough to lift up TSH in range, but should show some sign of improving (compared with prior taking ALC). 

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  • Posted


    Here's my TSH, Free T4, and Total T3.  My liver and wbc tests are normal to date. 


    <.01, 2.7, 281 and 325% TSI

    5mg Methimazole  w/1000mg lcarnitine and 500 acetyl carnitine a day


    <.01, 1.9,  202

    still taking 5mg M, 1,000mg l carnitine and 500-750mg acetyl carnitine a day


    <.01, 2. 209

    7.5mg methimazole and 500mg to 1,000mg l-carnitine and 500m to 750mg  acetyl alternating every day

    until the week before next test  when I added another 750mg acetyl carnitine a day


    <.01, 1.4, 166

    2000-2500 lcarnitine daily.  not using acetyl  since 9/17

    I take a lot of vitamins and supplements including Vit D - 3,000-4,000 a day, Magnesium 250mg a day, Fish Oil, Flaxseed Oil, ALA, etc.

    Thanks for your opinion.

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    • Posted

      Hi Goldi,

      You do have GD diagnosed with high TSI there. I am wondering why your TSH hasn't improved a bit after 3 months of taking enough dose of ALC and LC. Do you have mental symptoms, e.g., anxiety, depression, worries, irritating, etc? How about a digestion problem? GD is an autoimmune disorder and so you may want to go for a dietary check up and follow some dietary protocol if diagnosed. I wish you well.

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